| NPI | 1174525612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA C151409) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DC md035685) |
| 208000000X Pediatrics (Licence: CA C151409) | |
| 208000000X Pediatrics (Licence: PA MD419921) | |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2024-04-28 |